Thyroid

In vivo fluorescence of medullary carcinoma of the thyroid: A technology with potential to improve visualization of malignant tissue at surgical resection

July 31, 2008     Terence E. Johnson, MD, George A. Luiken, MD, Michael M. Quigley, MD, Mingxu Xu, MD, and Robert M. Hoffman, PhD
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Abstract

Medullary carcinoma of the thyroid requires aggressive treatment because of its potential to metastasize and because of the current limitations of preoperative localization and systemic therapy. If these tumors could be made to fluoresce in vivo with tagged fluorophore antibodies against tumor antigens, surgeons would be able obtain additional information in the operating room to facilitate a more complete resection. Based on the success of our previous work in breast and colon cancer models, we conducted an animal study of in vivo tumor fluorescence of a human medullary thyroid cell line in which bright tumor fluorescence is visible during dissection. To accomplish this, we used an inexpensive and commercially available handheld, blue (470 nm), light-emitting diode flashlight and filtered goggles (520 nm). This procedure, which we call the fluorescent antibody-assisted surgical technique (FAAST), is easy to perform, requires no complex or expensive technical equipment, and has the potential to be applied to a wide variety of tumors. To the best of our knowledge, this is the first experiment of its kind to be reported in the literature.

Acute vocal fold hemorrhage after thyroplasty

July 31, 2008     Robert Eller, MD, Mary Hawkshaw, RN, BSN, CORLN, and Robert T. Sataloff, MD, DMA
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Recurrent thyroid carcinoma

March 31, 2008     Sofia Avitia, MD, Jason S. Hamilton, MD, and Ryan F. Osborne, MD, FACS
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Minimally invasive endoscopic thyroidectomy

February 1, 2008     Sofia Avitia, MD, Jason S. Hamilton, MD, and Ryan F. Osborne, MD, FACS
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Diffuse hyperplasia of the thyroid gland (Graves' disease)

October 31, 2007     Lester D.R. Thompson, MD, FASCP
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Intratracheal ectopic thyroid: Case report and review

June 30, 2007     Bari Karakullukçu, MD; M. Güven Güvenç, MD; Harun Cansiz, MD; Fatih Öktem, MD; Büge Öz, MD
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Abstract
Intratracheal ectopic thyroid tissue is a rare abnormality that can cause airway obstruction. The symptoms can easily be confused with those of bronchial asthma. We describe the case of a 40-year-old man with subglottic thyroid tissue and multinodular goiter who had been misdiagnosed earlier with bronchial asthma. After the correct diagnosis was established, the lesion was excised via an external approach. We also discuss the clinical features and management of intratracheal thyroid tissue.

Hypothyroidism following hemithyroidectomy for benign nontoxic thyroid disease

April 30, 2007     Kristin A. Seiberling, MD; Jose C. Dutra, MD; Sanija Bajaramovic, MD
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Anaplastic thyroid carcinoma

April 30, 2007     Troy Hutchins, MD; Paul Friedlander, MD; Enrique Palacios, MD, FACR
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Parathyromatosis

January 1, 2007     Janette M. Carpenter, MSN, FNP; Peter G. Michaelson, MD; Thomas K. Lidner, MD; Michael L. Hinni, MD
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Columnar cell variant of papillary thyroid carcinoma

September 30, 2006     Chester P. Barton III, MD; Joseph A. Brennan, MD; Thomas R. Lowry, MD; Michael J. Russell, MD
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A case of papillary carcinoma arising in ectopic thyroid tissue within a branchial cyst with neck node metastasis

September 30, 2006     Rao K. Mehmood, MBBS, MD; Shaik I. Basha, MBBS, MS; Essan Ghareeb, MBBS
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Abstract
We describe the interesting case of a young man who presented with a lateral neck node that was diagnosed as a branchial cyst. Histopathology of the excised node revealed that a papillary carcinoma was located within thyroid tissue, which in turn was located within a branchial cyst. A total thyroidectomy with local lymph node clearance was performed. Histology identified a normal thyroid gland, but a papillary carcinoma in one of the excised lymph nodes was consistent with a metastasis. To our knowledge, this is only the second reported case of a thyroid carcinoma arising in ectopic thyroid tissue that metastasized in the neck.

Fibrin glue in thyroid and parathyroid surgery: Is under-flap suction still necessary?

July 31, 2006     Manish Patel, MD; Rohit Garg, MD; Dale H. Rice, MD
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Abstract
The introduction of fibrin sealants has brought into question the necessity of routinely placing suction drains. We conducted a retrospective study to determine whether fibrin sealants are comparable to traditional drains in terms of length of hospital stay and hematoma prevention. We evaluated 124 patients who had undergone thyroidectomy and 47 patients who had undergone parathyroidectomy. Of these, 22 thyroid surgery patients and 10 parathyroid surgery patients had their incisions closed without a drain after the application of fibrin glue. We found that the use of fibrin glue resulted in a statistically significant decrease in the length of hospital stay following both types of surgery (p = 0.033 and p = 0.022, respectively). Two hematomas in the drain group required immediate surgical evacuation; in both of these patients, the suction was clotted and ineffective. One minor hematoma occurred in the fibrin glue group, and it was opened at the bedside 24 hours after surgery. We conclude that fibrin sealants offer a comparative advantage over under-flap suction in both thyroid and parathyroid surgery. Also, fibrin glue is less expensive, and its use obviates the discomfort felt by patients when a drain is removed.
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